1. Name and Address of Reporting Person*
C/O H.I.G. CAPITAL |
1450 BRICKELL AVENUE, 31ST FLOOR |
(Street)
|
2. Date of Event Requiring Statement
(Month/Day/Year) 09/30/2015
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3. Issuer Name and Ticker or Trading Symbol
Surgery Partners, Inc.
[ SGRY ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
5. If Amendment, Date of Original Filed
(Month/Day/Year)
|
6. Individual or Joint/Group Filing (Check Applicable Line)
|
Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
|
1. Name and Address of Reporting Person*
C/O H.I.G. CAPITAL |
1450 BRICKELL AVENUE, 31ST FLOOR |
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
C/O H.I.G. CAPITAL |
1450 BRICKELL AVENUE, 31ST FLOOR |
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
C/O H.I.G. CAPITAL |
1450 BRICKELL AVENUE, 31ST FLOOR |
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
1. Name and Address of Reporting Person*
C/O H.I.G. CAPITAL |
1450 BRICKELL AVENUE, 31ST FLOOR |
(Street)
Relationship of Reporting Person(s) to Issuer
|
Director |
X |
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
|
|
|
|
H.I.G. Surgery Centers, LLC by H.I.G.-GPII, Inc. its manager, by: /s/ Richard H. Siegel, Vice President and General Counsel |
10/02/2015 |
|
H.I.G.-GPII, Inc. by: /s/ Richard H. Siegel, Vice President and General Counsel |
10/02/2015 |
|
Sami W. Mnaymneh by: /s/ Richard H. Siegel, Attorney-in-Fact |
10/02/2015 |
|
Anthony A. Tamer by: /s/ Richard H. Siegel, Attorney-in-Fact |
10/02/2015 |
|
** Signature of Reporting Person |
Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* If the form is filed by more than one reporting person,
see
Instruction
5
(b)(v). |
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |